FSA vs. HSA: Making Pre-Tax Dollars Work for Your Vision Care

What is a Flexible Spending Account (FSA)?

As the name implies, a flexible spending account, or FSA, gives you flexibility in how you pay for healthcare expenses. An FSA is an employer-sponsored benefit that allows you to set aside pre-tax money to use on eligible medical costs. Employers often offer FSAs alongside their workplace health insurance plans, and in some cases, you may be able to participate in an FSA even if you are not enrolled in the employer’s health plan. Contributions are generally taken directly from your paycheck, and you can use these funds for qualified health expenses, including vision care.

Once you choose how much to contribute to your FSA, that amount usually remains in place for the entire plan year unless you experience a qualifying life event that allows you to make a change. For 2026, the IRS allows employees to contribute up to $3,400 to a health FSA, although your employer may choose a lower maximum. Some employers also allow you to carry over a portion of unused funds into the next plan year. In 2026, the maximum permitted health FSA carryover is $680, if your employer offers this feature.

What Can an FSA Be Used for in Vision Care?

An FSA can be a convenient way to budget for both everyday and specialized vision needs. In many cases, you can use FSA dollars for the same services and products you receive at Nationwide Vision. Common FSA-eligible eye care expenses include:

• Comprehensive eye exams 

• Glasses, including lenses and frames 

• Prescription sunglasses 

• Contact lenses, solution, cleaners, and cases 

• Certain eye drops prescribed or recommended by your eye doctor 

• Eligible eye surgeries like LASIK or cataract surgery 

Nationwide Vision offers a wide selection of eye care services, glasses, and contact lenses that can often be purchased with FSA funds. If you are unsure whether a specific service or product is covered under your plan, our team can help you review your options and understand your choices before you pay.

What is a Health Savings Account (HSA)? 

A health savings account (HSA) is another type of tax-advantaged account that can be used to pay for qualified medical expenses, including many vision-related services. Like FSAs, HSAs are funded with pre-tax dollars, which can reduce your taxable income and help you stretch your healthcare budget. However, HSAs operate under a different set of rules and can offer additional long-term benefits. 

One of the biggest differences from an FSA is eligibility. To contribute to an HSA, you must be enrolled in a high-deductible health plan (HDHP) that meets IRS requirements. For 2026, an HSA-qualified HDHP must include at least:

• A minimum deductible of $1,700 for individual coverage or $3,400 for family coverage 

• A maximum out-of-pocket limit (including deductibles, copays, and coinsurance) of $8,500 for individuals or $17,000 for families 

Ownership is another key distinction. An HSA belongs to you, not your employer. Any money you do not spend stays in your account and rolls over from year to year. The account remains yours even if you change jobs or switch health plans in the future—you simply cannot continue contributing if you are no longer enrolled in an HSA-eligible plan.

What Can an HSA Be Used for in Vision Care?

HSA funds can generally be used for many of the same vision expenses as FSA dollars. Medically necessary vision care received at Nationwide Vision is typically considered a qualified medical expense. In most cases, HSA funds can be applied to the same types of costs as FSAs, including comprehensive eye exams and prescription eyewear.

Because HSA dollars do not expire at the end of the year, some patients choose to save these funds for larger or less frequent expenses. You might decide to use your HSA savings for laser vision correction, premium lens options, or future eye care needs as your vision changes with age. This long-term flexibility can make an HSA a powerful tool for managing both current and future vision care costs.

Comparing Tax-Free Accounts: The Differences for Vision Care

Both FSAs and HSAs can help you save money on eye care, but they work differently behind the scenes. Here is a side-by-side comparison focused on vision care:

Who can have the account?

• FSA: Only if your employer offers one. 

• HSA: Only if you are enrolled in an HSA-eligible HDHP. 

Who owns the account?

• FSA: The employer owns the account and unused funds may be forfeited or subject to grace period/carryover rules. 

• HSA: You own the account, meaning funds roll over year to year and move with you if you change jobs. 

Use it or lose it?

• FSA: Usually yes, except for limited grace periods or carryovers (up to the IRS limit if your employer allows it). 

• HSA: No. Funds remain in your account until you use them. 

Contribution limits for 2026?

• FSA: Up to $3,400 per year if your employer allows the maximum. 

• HSA: Up to $4,400 for self-only coverage or $8,750 for family coverage, plus a $1,000 catch-up contribution if you are 55 or older. 

How to Pay for Eye Care with an FSA

If you have an FSA and want to use it for vision care at Nationwide Vision, you can follow a few simple steps:

1. Check Your FSA Balance and Deadlines: Log into your FSA account portal or talk with your HR or benefits team to see how much money you have available and when your plan year ends. Ask whether your plan offers a carryover option or grace period and make sure you understand how those rules work so you do not leave money unused. 

2. Schedule Your Eye Exam: Book a comprehensive eye exam at your nearest Nationwide Vision location. Regular eye exams help keep your prescription current and give your eye doctor the opportunity to identify any issues early, when treatment is often simpler and more effective. 

3. Use FSA Funds at Your Appointment: In many cases, you can use FSA dollars to pay for exam copays, glasses, contact lenses, and other eligible vision services. Bring your FSA card if you have one, or save your itemized receipts and submit them to your FSA administrator for reimbursement. 

4. Plan Ahead for Year-End: If your FSA is based on a calendar year, think about using any remaining funds before December 31, or before your plan’s specific end date. Many patients use extra dollars on a backup pair of glasses, prescription sunglasses, lens upgrades, or an additional supply of contact lenses. 

How to Pay for Eye Care with an HSA

Health Savings Accounts offer extra flexibility for timing and long-term budgeting. Here is how you can use an HSA for your eye care at Nationwide Vision:

1. Confirm That Your Expense is HSA-Eligible: Most medically necessary vision expenses, including comprehensive eye exams, prescription glasses or contact lenses, and many eye surgeries, qualify as eligible costs. If you are unsure, review your HSA administrator’s list of covered expenses or reach out to them with questions. 

2. Pay Directly with Your HSA Debit Card: At checkout, you can often pay for eligible services and products using your HSA debit card. This allows you to use pre-tax dollars immediately for exam copays, glasses, contact lenses, and approved procedures. 

3. Pay Out-of-Pocket and Reimburse Yourself Later: Some people choose to pay with personal funds and then reimburse themselves from their HSA at a later date. This strategy can help you keep more money invested in your HSA for potential long-term growth. Be sure to save all receipts and follow your HSA administrator’s reimbursement process. 

4. Use Your HSA for Larger Vision Expenses: Because HSA funds roll over from year to year, many patients reserve part of their balance for bigger procedures or premium lens options. This can be especially helpful when planning for laser vision correction, cataract surgery, or other age-related eye care needs.